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Haraki S, Tsujisaka A, Shiraishi Y, Toyota R, Katagiri A, Toyoda H, Ishigaki S, Taniike M, Kato T. Reciprocal first night effect on rhythmic and non-rhythmic oromotor episodes in moderate to severe primary sleep bruxism: A retrospective physiological study. J Oral Rehabil 2024; 51:131-142. [PMID: 37077152 DOI: 10.1111/joor.13474] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Sleep on the first night in a sleep laboratory is characterized by a lower sleep quality and frequency of rhythmic masticatory muscle activity (RMMA) than that on the second night in moderate to severe sleep bruxism (SB) patients. OBJECTIVE The aims of this study was to clarify the physiological factors contributing to the first night effect on oromotor activity during sleep and investigate whether physiological factors involved in the first night effect differed between rhythmic and non-rhythmic oromotor activities. METHODS Polysomnographic data collected on two consecutive nights from 15 moderate to severe SB subjects (F 7: M 8; age: 23.2 ± 1.3 [mean ± SD] years) were retrospectively analysed. Sleep variables, RMMA and non-specific masticatory muscle activity (NSMA) were scored in relation to episode types (i.e. phasic or tonic and cluster or isolated), sleep architecture and transient arousals. The relationships between nightly differences in oromotor and sleep variables were assessed. The distribution of oromotor events, arousals, cortical electroencephalographic power, RR intervals and heart rate variability were examined in relation to sleep cycle changes. These variables were compared between the first and second nights and between RMMA and NSMA. RESULTS Sleep variables showed a lower sleep quality on Night 1 than on Night 2. In comparisons with Night 1, the RMMA index increased by 18.8% (p < .001, the Wilcoxon signed-rank test) on Night 2, while the NSMA index decreased by 17.9% (p = .041). Changes in the RMMA index did not correlate with those in sleep variables, while changes in the NSMA index correlated with those in arousal-related variables (p < .001, Spearman's rank correlation). An increase in the RMMA index on Night 2 was found for the cluster type and stage N1 related to sleep cyclic fluctuations in cortical and cardiac activities. In contrast, the decrease in the NSMA index was associated with increases in the isolated type and the occurrence of stage N2 and wakefulness regardless of the sleep cycle. CONCLUSION Discrepancies in first night effect on the occurrence of RMMA and NSMA represent unique sleep-related processes in the genesis of oromotor phenotypes in SB subjects.
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Affiliation(s)
- Shingo Haraki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Akiko Tsujisaka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuki Shiraishi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Risa Toyota
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Ayano Katagiri
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiroki Toyoda
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Shoichi Ishigaki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Masako Taniike
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Osaka University Hospital, Sleep Medicine Center, Osaka, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Osaka University Hospital, Sleep Medicine Center, Osaka, Japan
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Sprajcer M, Gupta C, Roach G, Sargent C. Can we put the first night effect to bed? An analysis based on a large sample of healthy adults. Chronobiol Int 2022; 39:1567-1573. [PMID: 36220800 DOI: 10.1080/07420528.2022.2133611] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The 'first night effect' refers to individuals experiencing poorer sleep during their first night in a laboratory. The effect is attributed to sleeping in a new environment, as well as wearing electrodes on the head and face, and is often cited as a reason for including an adaptation night in sleep research protocols. However, in the time since the 'first night effect' was initially reported, the conditions and equipment used in modern sleep laboratories have changed considerably, which may reduce the 'first night effect.' The aim of this study was to examine the impact of the 'first night effect' on sleep in a sample of healthy adults. Participants (n = 124; 22.7 ± 3.6 years) were given a 9-hour sleep opportunity (23:00-08:00 h) on two consecutive nights in a time-isolated sleep laboratory with sleep measured via polysomnography. Differences in dependent sleep variables between Night 1 and Night 2 were examined using paired t-tests. There was no difference in sleep onset latency (p = .295), total sleep time (p = .343), wake after sleep onset (p = .410), or sleep efficiency (p = .342) between Nights 1 and 2. However, participants spent more time in stage one (p = .001), and less time in stages two (p = .029) and three (p = .013) on Night 1 compared with Night 2. This suggests that, where primary sleep variables are the focus and not sleep architecture or arousals (e.g., where sleep is used as an independent variable), including an adaptation night may not be necessary.
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Affiliation(s)
- Madeline Sprajcer
- Appleton Institute, Central Queensland University, Adelaide, South Australia
| | - Charlotte Gupta
- Appleton Institute, Central Queensland University, Adelaide, South Australia
| | - Gregory Roach
- Appleton Institute, Central Queensland University, Adelaide, South Australia
| | - Charli Sargent
- Appleton Institute, Central Queensland University, Adelaide, South Australia
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McCarter SJ, Hagen PT, St Louis EK, Rieck TM, Haider CR, Holmes DR, Morgenthaler TI. Physiological markers of sleep quality: A scoping review. Sleep Med Rev 2022; 64:101657. [PMID: 35753151 DOI: 10.1016/j.smrv.2022.101657] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 05/16/2022] [Accepted: 05/29/2022] [Indexed: 10/18/2022]
Abstract
Understanding the associations between adequate sleep, performance and health outcomes is vital, yet a major limitation in the design and interpretation of studies of sleep and performance is the variability of subjective and objective markers used to assess sleep quality. The aim of this scoping review is to investigate how various physiological signals recorded during sleep or wakefulness relate to objective measures of cognitive or physical performance and subjectively perceived sleep quality to inform conceptual understanding of the elusive, amorphous, and multi-dimensional construct of sleep quality. We also aimed to suggest priorities for future areas of research in sleep quality and performance. We searched six databases ultimately yielding 439 studies after duplicate removal. Sixty-five studies were selected for full review. In general, correlations between objectively measured sleep and objective performance or subjectively assessed sleep quality were weak to moderate. Slow wave sleep was moderately correlated with better performance on tasks of vigilance, motor speed, and executive function as well as better subjective sleep quality and feeling well-rested, suggesting that slow wave sleep may be important for sleep quality and optimal daytime performance. However, these findings were inconsistent across studies. Increased sleep fragmentation was associated with poorer subjective sleep quality in both polysomnographic and actigraphic studies. Studies which simultaneously assessed physiologic sleep measures, performance measures and subjective sleep perception were few, limiting the ability to evaluate correlations between subjective and objective outcomes concurrently in the same individuals. Factors influencing the relationship between sleep quality and performance include circadian variability, sleep inertia, and mismatch between sleep stages studied and outcome measures of choice. Ultimately, the determination of "quality sleep" remains largely subjective and inconsistently quantifiable by current measures. Methods evaluating sleep as a continuous measure rather than traditional sleep stages may provide an intriguing approach to future studies of sleep and performance. Future well-designed studies using novel measures of sleep or multimodal ambulatory wearables assessing the three domains of sleep and performance (objective sleep physiology, objective performance, and subjective sleep quality) are needed to better define quality sleep.
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Affiliation(s)
- Stuart J McCarter
- Center for Sleep Medicine, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA.
| | - Philip T Hagen
- Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Erik K St Louis
- Center for Sleep Medicine, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Thomas M Rieck
- Mayo Clinic Healthy Living Program, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Clifton R Haider
- Section of Biostatistics, Mayo Clinic and Foundation, Rochester, MN, USA
| | - David R Holmes
- Section of Biostatistics, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Timothy I Morgenthaler
- Center for Sleep Medicine, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Pulmonology, Mayo Clinic and Foundation, Rochester, MN, USA
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Cudney LE, Frey BN, McCabe RE, Green SM. Investigating the relationship between objective measures of sleep and self-report sleep quality in healthy adults: a review. J Clin Sleep Med 2022; 18:927-936. [PMID: 34609276 PMCID: PMC8883085 DOI: 10.5664/jcsm.9708] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Sleep is one of the most common factors related to health, yet a standard definition of sleep quality has not been identified. Polysomnography provides important information about objective sleep variables. However, the relationship between objective sleep variables and perception of sleep quality remains unclear. The purpose of this review was to (1) summarize the current methods of measuring objective sleep macrostructure and microstructure, including electroencephalography arousals, spectral frequency, cyclic alternating pattern, and self-report sleep quality, and (2) investigate the relationship between objective measures of sleep physiology and self-report sleep quality in healthy adults. METHODS A literature search was conducted using Medline, PubMed, and PsycInfo databases and cited reference searches. Eligible studies included a comparison between self-report sleep quality and polysomnography sleep measures in healthy adults. RESULTS Thirteen studies were identified. Measurement of self-report sleep quality varied widely across studies. Total sleep time and sleep efficiency were most consistently related to sleep quality, while other objective sleep variables, including electroencephalography spectral analysis, were not reliably predictive of self-report sleep quality in healthy adults. There is preliminary support that microstructural sleep analysis with cyclic alternating pattern may be related to self-reported sleep quality. CONCLUSIONS Further research is needed to define and standardize self-report measures of sleep quality and investigate the microstructure of sleep. Objective measures of sleep and experiences of "quality" sleep are not as closely related as one may expect in healthy individuals, and understanding this relationship further is necessary to improve the clinical utility of sleep physiology. CITATION Cudney LE, Frey BN, McCabe RE, Green SM. Investigating the relationship between objective measures of sleep and self-report sleep quality in healthy adults: a review. J Clin Sleep Med. 2022;18(3):927-936.
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Affiliation(s)
- Lauren E. Cudney
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada,Women’s Health Concerns Clinic, The Research Institute of St. Joe’s Hamilton, Hamilton, Ontario, Canada,Address correspondence to: Lauren E. Cudney, MSc, St. Joseph’s Healthcare Hamilton, Women’s Health Concerns Clinic, 100 West 5th St., Hamilton, ON, Canada, L8N 3K7; Tel: (905) 522-1155 ext. 33672;
| | - Benicio N. Frey
- Women’s Health Concerns Clinic, The Research Institute of St. Joe’s Hamilton, Hamilton, Ontario, Canada,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Randi E. McCabe
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada,Mental Health and Addictions Program, The Research Institute of St. Joe’s Hamilton, Hamilton, Ontario, Canada
| | - Sheryl M. Green
- Women’s Health Concerns Clinic, The Research Institute of St. Joe’s Hamilton, Hamilton, Ontario, Canada,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Examining First Night Effect on Sleep Parameters with hd-EEG in Healthy Individuals. Brain Sci 2022; 12:brainsci12020233. [PMID: 35203996 PMCID: PMC8870064 DOI: 10.3390/brainsci12020233] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 12/04/2022] Open
Abstract
Difficulty sleeping in a novel environment is a common phenomenon that is often described as the first night effect (FNE). Previous works have found FNE on sleep architecture and sleep power spectra parameters, especially during non-rapid eye movement (NREM) sleep. However, the impact of FNE on sleep parameters, including local differences in electroencephalographic (EEG) activity across nights, has not been systematically assessed. Here, we performed high-density EEG sleep recordings on 27 healthy individuals on two nights and examined differences in sleep architecture, NREM (stages 2 and 3) EEG power spectra, and NREM power topography across nights. We found higher wakefulness after sleep onset (WASO), reduced sleep efficiency, and less deep NREM sleep (stage 3), along with increased high-frequency NREM EEG power during the first night of sleep, corresponding to small to medium effect sizes (Cohen’s d ≤ 0.5). Furthermore, study individuals showed significantly lower slow-wave activity in right frontal/prefrontal regions as well as higher sigma and beta activities in medial and left frontal/prefrontal areas, yielding medium to large effect sizes (Cohen’s d ≥ 0.5). Altogether, these findings suggest the FNE is characterized by less efficient, more fragmented, shallower sleep that tends to affect especially certain brain regions. The magnitude and specificity of these effects should be considered when designing sleep studies aiming to compare across night effects.
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Shirota A, Kamimura M, Kishi A, Adachi H, Taniike M, Kato T. Discrepancies in the Time Course of Sleep Stage Dynamics, Electroencephalographic Activity and Heart Rate Variability Over Sleep Cycles in the Adaptation Night in Healthy Young Adults. Front Physiol 2021; 12:623401. [PMID: 33867997 PMCID: PMC8044772 DOI: 10.3389/fphys.2021.623401] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/12/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The aim of the present study was to characterize the cyclic sleep processes of sleep-stage dynamics, cortical activity, and heart rate variability during sleep in the adaptation night in healthy young adults. METHODS Seventy-four healthy adults participated in polysomnographic recordings on two consecutive nights. Conventional sleep variables were assessed according to standard criteria. Sleep-stage continuity and dynamics were evaluated by sleep runs and transitions, respectively. These variables were compared between the two nights. Electroencephalographic and cardiac activities were subjected to frequency domain analyses. Cycle-by-cycle analysis was performed for the above variables in 34 subjects with four sleep cycles and compared between the two nights. RESULTS Conventional sleep variables reflected lower sleep quality in the adaptation night than in the experimental night. Bouts of stage N1 and stage N2 were shorter, and bouts of stage Wake were longer in the adaptation night than in the experimental night, but there was no difference in stage N3 or stage REM. The normalized transition probability from stage N2 to stage N1 was higher and that from stage N2 to N3 was lower in the adaptation night, whereas that from stage N3 to other stages did not differ between the nights. Cycle-by-cycle analysis revealed that sleep-stage distribution and cortical beta EEG power differed between the two nights in the first sleep cycle. However, the HF amplitude of the heart rate variability was lower over the four sleep cycles in the adaptation night than in the experimental night. CONCLUSION The results suggest the distinct vulnerability of the autonomic adaptation processes within the central nervous system in young healthy subjects while sleeping in a sleep laboratory for the first time.
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Affiliation(s)
- Ai Shirota
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Mayo Kamimura
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Akifumi Kishi
- Graduate School of Education, The University of Tokyo, Bunkyo-ku, Japan
| | - Hiroyoshi Adachi
- Osaka University Hospital, Sleep Medicine Center, Suita, Japan
- Osaka University Health and Counseling Center, Toyonaka, Japan
| | - Masako Taniike
- Osaka University Hospital, Sleep Medicine Center, Suita, Japan
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
- Osaka University Hospital, Sleep Medicine Center, Suita, Japan
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Japan
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7
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Wu D, Tong M, Ji Y, Ruan L, Lou Z, Gao H, Yang Q. REM Sleep Fragmentation in Patients With Short-Term Insomnia Is Associated With Higher BDI Scores. Front Psychiatry 2021; 12:733998. [PMID: 34566728 PMCID: PMC8458740 DOI: 10.3389/fpsyt.2021.733998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To observe the changes in sleep characteristics and BDI scores in patients with short-term insomnia disorder (SID) using a longitudinal observational study. Methods: Fifty-four patients who met the criteria for SID of the International Classification of Sleep Disorders, third edition, were recruited. Depression levels were assessed using the Beck depression inventory (BDI) at enrollment and after 3 months of follow-up, respectively. Sleep characteristics were assessed by polysomnography. Results: After 3 months of follow-up, the group was divided into SID with increased BDI score (BDI >15) and SID with normal BDI score (BDI ≤ 15) according to the total BDI score of the second assessment. The differences in rapid eye movement (REM) sleep latency, REM sleep arousal index, and NREM sleep arousal index between the two groups were statistically significant. The total BDI score was positively correlated with REM and NREM sleep arousal index and negatively correlated with REM sleep latency, which were analyzed by Pearson correlation coefficient. Multiple linear regression was used to construct a regression model to predict the risk of depression in which the prediction accuracy reached 83.7%. Conclusion: REM sleep fragmentation is closely associated with future depressive status in patients with SID and is expected to become an index of estimating depression risk.
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Affiliation(s)
- Danjuan Wu
- Sleep Disorder Diagnosis and Treatment Center, Department of Psychiatric, Ningbo City First Hospital, Ningbo Hospital of Zhejiang University, Zhejiang, China
| | - Maoqing Tong
- Sleep Disorder Diagnosis and Treatment Center, Department of Psychiatric, Ningbo City First Hospital, Ningbo Hospital of Zhejiang University, Zhejiang, China
| | - Yunxin Ji
- Sleep Disorder Diagnosis and Treatment Center, Department of Psychiatric, Ningbo City First Hospital, Ningbo Hospital of Zhejiang University, Zhejiang, China
| | - Liemin Ruan
- Sleep Disorder Diagnosis and Treatment Center, Department of Psychiatric, Ningbo City First Hospital, Ningbo Hospital of Zhejiang University, Zhejiang, China
| | - Zhongze Lou
- Sleep Disorder Diagnosis and Treatment Center, Department of Psychiatric, Ningbo City First Hospital, Ningbo Hospital of Zhejiang University, Zhejiang, China.,Central Laboratory of the Medical Research Center, Ningbo City First Hospital, Ningbo Hospital of Zhejiang University, Zhejiang, China
| | - He Gao
- Department of Psychiatric, Ningbo Kangning Hospital, Zhejiang, China
| | - Qing Yang
- Sleep Disorder Diagnosis and Treatment Center, Department of Psychiatric, Ningbo City First Hospital, Ningbo Hospital of Zhejiang University, Zhejiang, China
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Virtanen I, Kalleinen N, Urrila AS, Polo-Kantola P. First-Night Effect on Sleep in Different Female Reproductive States. Behav Sleep Med 2018; 16:437-447. [PMID: 27700195 DOI: 10.1080/15402002.2016.1228646] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES In sleep laboratory studies, the new environment is generally considered to disturb sleep during the first night. However, older women have rarely been studied. Although menopause and hormone therapy affect sleep, their impact on the first-night effect is virtually unknown. PARTICIPANTS Four groups of women with no sleep laboratory experience: young on hormonal contraceptives (n = 11, 23.1 [0.5] years), perimenopausal (n = 15, 48.0 [0.4] years), postmenopausal without hormone therapy (HT; off-HT, n = 22, 63.4 [0.8] years) and postmenopausal with HT (n = 16, 63.1 [0.9] years). PROCEDURE A cross-sectional study. METHODS Polysomnography was performed over two consecutive nights and the first-night effect and group differences were evaluated. Questionnaire-based insomnia and sleepiness scores were correlated to sleep variables and their between-night changes. RESULTS Although sleep in young women was deeper and less fragmented than in the other groups, first-night effect was similar in all study groups. Total sleep time, sleep efficiency, and S1 and S2 sleep increased, and wake after sleep onset, awakenings per hour of sleep, S2 and REM latencies, and percentage of SWS decreased from the first to the second night. Perimenopausal women had more insomnia complaints than other women. Insomnia complaints were associated with more disturbed sleep but not with the first-night effect. CONCLUSIONS A first night in a sleep laboratory elicits a marked interference of sleep architecture in women of all ages, with a carryover effect of lighter sleep on the second study night. Menopausal state, HT use, or insomnia complaints do not modify this effect.
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Affiliation(s)
- Irina Virtanen
- a Department of Clinical Neurophysiology , TYKS-SAPA, Hospital District of Southwest Finland , Turku , Finland.,b Sleep Research Unit , University of Turku , Turku , Finland
| | - Nea Kalleinen
- b Sleep Research Unit , University of Turku , Turku , Finland.,c Department of Cardiology , Satakunta Central Hospital , Pori , Finland
| | - Anna S Urrila
- d Department of Health, Mental Health Unit , National Institute for Health and Welfare , Helsinki , Finland.,e Department of Adolescent Psychiatry , Helsinki University Hospital , Helsinki , Finland
| | - Päivi Polo-Kantola
- b Sleep Research Unit , University of Turku , Turku , Finland.,f Department of Obstetrics and Gynecology , Turku University Hospital and University of Turku , Turku , Finland
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9
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The use of accelerometry as a tool to measure disturbed nocturnal sleep in Parkinson's disease. NPJ PARKINSONS DISEASE 2018; 4:1. [PMID: 29354683 PMCID: PMC5762674 DOI: 10.1038/s41531-017-0038-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/29/2017] [Accepted: 12/12/2017] [Indexed: 11/09/2022]
Abstract
Sleep disturbances are common in Parkinson’s disease (PD). We used the Parkinson’s KinetiGraph (PKG), an objective movement recording system for PD to assess night time sleep in 155 people aged over 60 and without PD (controls), 72 people with PD (PwP) and 46 subjects undergoing a Polysomnogram (PSG: 36 with sleep disorder and 10 with normal sleep). The PKG system uses a wrist worn logger to capture acceleration and derive a bradykinesia score (BKS) every 2 min over 6 days. The BKS ranges from 0–160 with higher scores associated with lesser mobility. Previously we showed that BKS > 80 were associated with day time sleep and used this to produce scores for night time sleep: Efficiency (Percent time with BKS > 80), Fragmentation (Average duration of runs of BKS > 80) and Sleep Quality (BKS > 111 as a representation of atonia). There was a fair association with BKS score and sleep level as judged by PSG. Using these PKG scores, it was possible to distinguish between normal and abnormal PSG studies with good Selectivity (86%) and Sensitivity (80%). The PKG’s sleep scores were significantly different in PD and Controls and correlated with a subject’s self-assessment (PDSS 2) of the quality, wakefulness and restlessness. Using both the PDSS 2 and the PKG, it was apparent that sleep disturbances were apparent early in disease in many PD subjects and that subjects with poor night time sleep were more likely to have day time sleepiness. This system shows promise as a quantitative score for assessing sleep in Parkinson’s disease. A movement recording system reveals the occurrence of sleep disturbances in the early stages of Parkinson’s disease (PD). Malcolm Horne, a movement disorders expert at the University in Melbourne, and colleagues assessed night time sleep in 72 patients with PD using a wrist-worn device that captures movement patterns. The Parkinson’s KinetiGraph (PKG) system derives scores that are associated with sleep stages and correlate with patients’ self-assessment of sleep quality, wakefulness and restlessness. Significant differences between the PKG sleep scores of PD patients and age-matched healthy controls confirmed that night time sleep disturbances and day time sleepiness worsen as the disease progresses. Abnormal PKG scores were found in patients affected by the disease for only 3 years highlighting the extent to which sleep is disrupted in early-stage PD.
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10
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Blackwell T, Paudel M, Redline S, Ancoli-Israel S, Stone KL. A novel approach using actigraphy to quantify the level of disruption of sleep by in-home polysomnography: the MrOS Sleep Study: Sleep disruption by polysomnography. Sleep Med 2017; 32:97-104. [PMID: 28366349 PMCID: PMC5380148 DOI: 10.1016/j.sleep.2016.11.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND The "first-night effect" of polysomnography (PSG) has been previously studied; however, the ability to quantify the sleep disruption level has been confounded with the use of PSG on all nights. We used actigraphy to quantify disruption level and examined characteristics associated with disruption. METHODS Totally, 778 older men (76.2 ± 5.4 years) from a population-based study at six US centers underwent one night of in-home PSG. Actigraphy was performed on the PSG night and three subsequent nights. Actigraphically measured total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), and sleep onset latency (SOL) from the PSG night and subsequent nights were compared. Linear regression models were used to examine the association of characteristics and sleep disruption. RESULTS On average, sleep on the PSG night was worse than the following night (p < 0.05, TST 21 ± 85 min less, SE 2.3 ± 11.3% less, WASO 4.9 ± 51.8 min more, SOL 6.6 ± 56.2 min more). Sleep on the PSG night was significantly worse than that two and three nights later. Characteristics associated with greater sleep disruption on the PSG night included older age, higher apnea-hypopnea index, worse neuromuscular function, and more depressive symptoms. Minorities and men with excessive daytime sleepiness slept somewhat better on the PSG night. CONCLUSIONS Among older men, there was sleep disruption on the PSG night, which may lead to sleep time underestimation. The increase of sleep on the night after the PSG suggests that data from the second monitoring may overestimate sleep.
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Affiliation(s)
- Terri Blackwell
- California Pacific Medical Center Research Institute, San Francisco, CA, United States.
| | - Misti Paudel
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, United States
| | - Susan Redline
- Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Sonia Ancoli-Israel
- Department of Psychiatry and Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Katie L Stone
- California Pacific Medical Center Research Institute, San Francisco, CA, United States
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11
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Tu Q, Heitkemper MM, Jarrett ME, Buchanan DT. Sleep disturbances in irritable bowel syndrome: a systematic review. Neurogastroenterol Motil 2017; 29. [PMID: 27683238 DOI: 10.1111/nmo.12946] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/21/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Sleep disturbances are well-documented among persons with irritable bowel syndrome (IBS). Difficulty in falling asleep, shorter sleep time, frequent arousal and awakenings, or non-restorative sleep are the most common manifestations. Sleep disturbances are also related to a higher risk of having IBS. Some researchers have provided evidence of a positive association between poorer subjective sleep quality and increased severity and frequency in gastrointestinal (GI) symptoms in those with IBS. However, findings from studies using objective sleep and activity measures, such as polysomnography and actigraphy, are inconclusive. PURPOSE This systematic review of the literature between 1990 and 2015 evaluates the evidence of sleep disturbances in adults with IBS and their relationship with GI symptoms.
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Affiliation(s)
- Q Tu
- Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington School of Nursing, Seattle, WA, USA
| | - M M Heitkemper
- Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington School of Nursing, Seattle, WA, USA
| | - M E Jarrett
- Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington School of Nursing, Seattle, WA, USA
| | - D T Buchanan
- Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington School of Nursing, Seattle, WA, USA
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12
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Hilz MJ, Moeller S, Buechner S, Czarkowska H, Ayappa I, Axelrod FB, Rapoport DM. Obstructive Sleep-Disordered Breathing Is More Common than Central in Mild Familial Dysautonomia. J Clin Sleep Med 2016; 12:1607-1614. [PMID: 27655467 DOI: 10.5664/jcsm.6342] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 07/19/2016] [Indexed: 01/22/2023]
Abstract
STUDY OBJECTIVES In familial dysautonomia (FD) patients, sleep-disordered breathing (SDB) might contribute to their high risk of sleep-related sudden death. Prevalence of central versus obstructive sleep apneas is controversial but may be therapeutically relevant. We, therefore, assessed sleep structure and SDB in FD-patients with no history of SDB. METHODS 11 mildly affected FD-patients (28 ± 11 years) without clinically overt SDB and 13 controls (28 ± 10 years) underwent polysomnographic recording during one night. We assessed sleep stages, obstructive and central apneas (≥ 90% air flow reduction) and hypopneas (> 30% decrease in airflow with ≥ 4% oxygen-desaturation), and determined obstructive (oAI) and central (cAI) apnea indices and the hypopnea index (HI) as count of respective apneas/hypopneas divided by sleep time. We obtained the apnea-hypopnea index (AHI4%) from the total of apneas and hypopneas divided by sleep time. We determined differences between FD-patients and controls using the U-test and within-group differences between oAIs, cAIs, and HIs using the Friedman test and Wilcoxon test. RESULTS Sleep structure was similar in FD-patients and controls. AHI4% and HI were significantly higher in patients than controls. In patients, HIs were higher than oAIs and oAIs were higher than cAIs. In controls, there was no difference between HIs, oAIs, and cAIs. Only patients had apneas and hypopneas during slow wave sleep. CONCLUSIONS In our FD-patients, obstructive apneas were more common than central apneas. These findings may be related to FD-specific pathophysiology. The potential ramifications of SDB in FD-patients suggest the utility of polysomnography to unveil SDB and initiate treatment. COMMENTARY A commentary on this article appears in this issue on page 1583.
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Affiliation(s)
- Max J Hilz
- Department of Neurology, University of Erlangen-Nürnberg, Erlangen, Germany.,Autonomic Unit, University Colloge of London, Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Sebastian Moeller
- Department of Neurology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Susanne Buechner
- Department of Neurology, General Hospital of Bozen/Bolzano, Bozen/Bolzano, Italy
| | - Hanna Czarkowska
- Cushing Neuroscience Institute, NS-LIJ Health System, Great Neck, NY
| | - Indu Ayappa
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY
| | - Felicia B Axelrod
- Dysautonomia Center, New York University Langone School of Medicine, New York, NY
| | - David M Rapoport
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY
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13
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Abstract
OBJECTIVES Evidence of a 'first night effect' has been documented for polysomnography. The possibility of this has not been previously assessed in wrist actigraphy, yet may have important implications for the study design of future sleep research. We sought to examine potential evidence of a 'first night effect' for wrist actigraphy in adolescents across weekdays and weekend nights for multiple sleep outcomes. DESIGN 3-year prospective cohort study (Midlands Adolescent Schools Sleep Education Study). SETTING 8 secondary schools in the Midlands region of the UK. PARTICIPANTS Adolescents (aged 11-13 years at baseline) were recruited to the study and were requested to wear a wrist actigraph for 7 consecutive days/nights at baseline and then annually for 2 years during the second term of the academic year. PRIMARY OUTCOME MEASURES We compared multiple sleep outcomes (total sleep time, wake after sleep onset, sleep efficiency, sleep onset latency, number of awakenings, length of awakenings, sleep onset time) when the device was worn on a weekday and weekend and compared these to other nights to identify possible evidence of a 'first night effect' for wrist actigraphy. RESULTS No significant differences were found between any sleep outcomes when the first night of wrist actigraphy was on a weekday compared with other weekdays. When the first night was measured on a weekend (Friday), average total sleep time was significantly greater (486±5 min) compared with the second night (Saturday; 469±6 min), p=0.01. CONCLUSIONS We found no evidence to support a 'first night effect' for wrist actigraphy in our adolescent sample. The first night of actigraphy data should not be disregarded in future studies that deploy this technique to measure sleep over prolonged time periods.
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Affiliation(s)
- Teresa Arora
- Department of Medicine and Clinical Research Core, Weill Cornell Medicine in New York USA, Doha, Qatar
| | - Omar M Omar
- Department of Medicine and Clinical Research Core, Weill Cornell Medicine in New York USA, Doha, Qatar
| | - Shahrad Taheri
- Department of Medicine and Clinical Research Core, Weill Cornell Medicine in New York USA, Doha, Qatar
- Department of Medicine, King's College London, London, UK
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14
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Myllymaa S, Muraja-Murro A, Westeren-Punnonen S, Hukkanen T, Lappalainen R, Mervaala E, Töyräs J, Sipilä K, Myllymaa K. Assessment of the suitability of using a forehead EEG electrode set and chin EMG electrodes for sleep staging in polysomnography. J Sleep Res 2016; 25:636-645. [PMID: 27230805 DOI: 10.1111/jsr.12425] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 04/09/2016] [Indexed: 12/01/2022]
Abstract
Recently, a number of portable devices designed for full polysomnography at home have appeared. However, current scalp electrodes used for electroencephalograms are not practical for patient self-application. The aim of this study was to evaluate the suitability of recently introduced forehead electroencephalogram electrode set and supplementary chin electromyogram electrodes for sleep staging. From 31 subjects (10 male, 21 female; age 31.3 ± 11.8 years), sleep was recorded simultaneously with a forehead electroencephalogram electrode set and with a standard polysomnography setup consisting of six recommended electroencephalogram channels, two electrooculogram channels and chin electromyogram. Thereafter, two experienced specialists scored each recording twice, based on either standard polysomnography or forehead recordings. Sleep variables recorded with the forehead electroencephalogram electrode set and separate chin electromyogram electrodes were highly consistent with those obtained with the standard polysomnography. There were no statistically significant differences in total sleep time, sleep efficiency or sleep latencies. However, compared with the standard polysomnography, there was a significant increase in the amount of stage N1 and N2, and a significant reduction in stage N3 and rapid eye movement sleep. Overall, epoch-by-epoch agreement between the methods was 79.5%. Inter-scorer agreement for the forehead electroencephalogram was only slightly lower than that for standard polysomnography (76.1% versus 83.2%). Forehead electroencephalogram electrode set as supplemented with chin electromyogram electrodes may serve as a reliable and simple solution for recording total sleep time, and may be adequate for measuring sleep architecture. Because this electrode concept is well suited for patient's self-application, it may offer a significant advancement in home polysomnography.
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Affiliation(s)
- Sami Myllymaa
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland
| | - Anu Muraja-Murro
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland
| | | | - Taina Hukkanen
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland
| | - Reijo Lappalainen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Esa Mervaala
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland
| | - Kirsi Sipilä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Oral and Maxillofacial Department, Kuopio University Hospital, Kuopio, Finland.,Institute of Dentistry, University of Oulu, Oulu, Finland.,Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Katja Myllymaa
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland
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15
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Somatic arousal and sleepiness/fatigue among patients with sleep-disordered breathing. Sleep Breath 2016; 20:749-58. [PMID: 26739833 DOI: 10.1007/s11325-015-1294-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/02/2015] [Accepted: 12/08/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES In a large clinical sample, we tested the hypothesis that levels of sleepiness and fatigue among upper airway resistance syndrome (UARS) patients are correlated with levels of somatic arousal (SA; reflecting the sympathetic nervous system component of the stress response). We also tested the correlations of post-treatment change in these three parameters, and we extended the investigation to obstructive sleep apnea/hypopnea (OSA/H) patients. METHODS From 5 years of patient data, we obtained scores on the body sensation questionnaire (BSQ), measuring the level of SA, the fatigue severity scale (FSS), and Epworth sleepiness scale (ESS) for 152 consecutive UARS patients and 150 consecutive OSA/H patients. For each group, we correlated the FSS and ESS scores with the BSQ scores. Among the 45 UARS patients and 49 OSA/H patients treated with nasal CPAP who provided post-treatment data, we correlated change in FSS and ESS scores with change in BSQ scores. RESULTS Scores on the BSQ, FSS, and ESS for UARS patients and OSA/H patients were comparable. In both UARS and OSA/H patients, both the FSS and ESS scores were positively correlated with the BSQ score. Nasal CPAP use decreased all three questionnaire scores in both patient groups. In the pooled data, changes in FSS were significantly correlated with changes in BSQ. CONCLUSIONS Our findings confirm our preliminary observations that sleepiness and fatigue among UARS patients are correlated with their level of SA and suggest that the same is true for OSA/H patients. The decrease of SA following treatment suggests that SDB is a cause of SA among patients with UARS and OSA/H.
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16
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Lyons OD, Chan CT, Yadollahi A, Bradley TD. Effect of ultrafiltration on sleep apnea and sleep structure in patients with end-stage renal disease. Am J Respir Crit Care Med 2015; 191:1287-94. [PMID: 25822211 DOI: 10.1164/rccm.201412-2288oc] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
RATIONALE In end-stage renal disease (ESRD), a condition characterized by fluid overload, both obstructive and central sleep apnea (OSA and CSA) are common. This observation suggests that fluid overload is involved in the pathogenesis of OSA and CSA in this condition. OBJECTIVES To test the hypothesis that fluid removal by ultrafiltration (UF) will reduce severity of OSA and CSA in patients with ESRD. METHODS At baseline, on a nondialysis day, patients with ESRD on thrice-weekly hemodialysis underwent overnight polysomnography along with measurement of total body extracellular fluid volume (ECFV), and ECFV of the neck, thorax, and right leg before and after sleep. The following week, on a nondialysis day, subjects with an apnea-hypopnea index (AHI) greater than or equal to 20 had fluid removed by UF, followed by repeat overnight polysomnography with fluid measurements. MEASUREMENTS AND MAIN RESULTS Fifteen patients (10 men) with an AHI greater than or equal to 20 (10 OSA; 5 CSA) participated. Mean age was 53.5 ± 10.4 years and mean body mass index was 25.3 ± 4.8 kg/m(2). Following removal of 2.17 ± 0.45 L by UF, the AHI decreased by 36% (43.8 ± 20.3 to 28.0 ± 17.7; P < 0.001) without affecting uremia. The reduction in AHI correlated with the reduction in total body ECFV (r = 0.567; P = 0.027) and was associated with reductions in ECFV of the right leg (P = 0.001), overnight change in ECFV of the right leg (P = 0.044), ECFV of the thorax (P = 0.001), and ECFV of the neck (P = 0.003). CONCLUSIONS These findings indicate that fluid overload contributes to the pathogenesis of OSA and CSA in ESRD, and that fluid removal by UF attenuates sleep apnea without altering uremic status.
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Affiliation(s)
- Owen D Lyons
- 1 Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, Canada
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17
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Butt M, Quan SF, Pentland AS, Khayal I. Gender Differences in Real-Home Sleep of Young and Older Couples. SOUTHWEST JOURNAL OF PULMONARY AND CRITICAL CARE 2015; 10:289-299. [PMID: 26110099 DOI: 10.13175/swjpcc068-15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
STUDY OBJECTIVES To understand gender differences in sleep quality, architecture and duration of young healthy couples in comparison to older couples in their natural sleep environment. DESIGN Sleep was monitored in a naturalistic setting using a headband sleep monitoring device over a period of two weeks for young couples and home polysomnography for the older couples. PARTICIPANTS Ten heterosexual young couples (male mean age: 28.2±1.0[SD] years/female mean age: 26.8±0.9 years) and 14 older couples (male mean age: 59.3±9.6 years/female mean age: 58.8±9.1 years). MEASUREMENTS AND RESULTS In the young couples, total sleep time (395±66 vs. 367±54 min., p<0.05), sleep efficiency (97.0±3.0 vs. 91.1±7.9, p<0.001), and % REM (31.1±4.8 vs. 23.6±5.5, p<0.001) in males was higher than in females. In contrast, % light sleep (51.7±7.1 vs. 59.7±6.7, p<0.001) and number of arousals (2.9±1.9 vs. 5.3±1.9, p<0.001) were lower. These differences persisted after controlling for evening mood and various evening pre-sleep activities. In the older couples, there were no differences between genders. In addition, children in the household adversely impacted sleep. CONCLUSIONS In couples recorded in the home, young males slept longer and had better sleep quality than young females. This difference appears to dissipate with age. In-home assessment of couples can aid in understanding of gender differences in sleep and how they are affected by age and social environment.
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Affiliation(s)
- Maryam Butt
- Masdar Institute of Science and Technology, Abu Dhabi, UAE
| | - Stuart F Quan
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA ; Arizona Respiratory Center, University of Arizona College of Medicine, Tucson, AZ, USA ; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Inas Khayal
- Masdar Institute of Science and Technology, Abu Dhabi, UAE ; Massachusetts Institute of Technology, Cambridge, MA, USA
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18
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Moser D. „Cyclic alternating pattern“. SOMNOLOGIE 2015. [DOI: 10.1007/s11818-015-0698-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Hirscher V, Unbehaun T, Feige B, Nissen C, Riemann D, Spiegelhalder K. Patients with primary insomnia in the sleep laboratory: do they present with typical nights of sleep? J Sleep Res 2015; 24:383-9. [PMID: 25659408 DOI: 10.1111/jsr.12280] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 12/20/2014] [Indexed: 10/24/2022]
Abstract
The validity of sleep laboratory investigations in patients with insomnia is important for researchers and clinicians. The objective of this study was to examine the first-night effect and the reverse first-night effect in patients with chronic primary insomnia compared with good sleeper controls. A retrospective comparison of a well-characterised sample of 50 patients with primary insomnia and 50 good sleeper controls was conducted with respect to 2 nights of polysomnography, and subjective sleep parameters in the sleep laboratory and the home setting. When comparing the first and second sleep laboratory night, a significant first-night effect was observed across both groups in the great majority of the investigated polysomnographic and subjective variables. However, patients with primary insomnia and good sleeper controls did not differ with respect to this effect. Regarding the comparison between the sleep laboratory nights and the home setting, unlike good sleeper controls, patients with primary insomnia reported an increased subjective sleep efficiency on both nights (in part due to a reduced bed time) and an increased subjective total sleep time on the second night. These results suggest that even the second sleep laboratory night does not necessarily provide clinicians and researchers with a representative insight into the sleep perception of patients with primary insomnia. Future studies should investigate whether these findings also hold for other patient populations.
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Affiliation(s)
- Verena Hirscher
- Division of Psychosomatic Medicine, Kantonspital St. Gallen, St. Gallen, Switzerland
| | - Thomas Unbehaun
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
| | - Christoph Nissen
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
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20
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Kis A, Szakadát S, Simor P, Gombos F, Horváth K, Bódizs R. Objective and subjective components of the first-night effect in young nightmare sufferers and healthy participants. Behav Sleep Med 2014; 12:469-80. [PMID: 24294972 DOI: 10.1080/15402002.2013.829062] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The first-night effect--marked differences between the first- and the second-night sleep spent in a laboratory--is a widely known phenomenon that accounts for the common practice of excluding the first-night sleep from any polysomnographic analysis. The extent to which the first-night effect is present in a participant, as well as its duration (1 or more nights), might have diagnostic value and should account for different protocols used for distinct patient groups. This study investigated the first-night effect on nightmare sufferers (NM; N = 12) and healthy controls (N = 15) using both objective (2-night-long polysomnography) and subjective (Groningen Sleep Quality Scale for the 2 nights spent in the laboratory and 1 regular night spent at home) methods. Differences were found in both the objective (sleep efficiency, wakefulness after sleep onset, sleep latency, Stage-1 duration, Stage-2 duration, slow-wave sleep duration, and REM duration) and subjective (self-rating) variables between the 2 nights and the 2 groups, with a more pronounced first-night effect in the case of the NM group. Furthermore, subjective sleep quality was strongly related to polysomnographic variables and did not differ among 1 regular night spent at home and the second night spent in the laboratory. The importance of these results is discussed from a diagnostic point of view.
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Affiliation(s)
- Anna Kis
- a Department of Cognitive Sciences Budapest University of Technology and Economics
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21
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Technologically sensed social exposure related to slow-wave sleep in healthy adults. Sleep Breath 2014; 19:255-61. [PMID: 24862352 DOI: 10.1007/s11325-014-1005-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 05/01/2014] [Accepted: 05/05/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study is to understand the relationship between automatically captured social exposure and detailed sleep parameters of healthy young adults. METHODS This study was conducted in a real-world setting in a graduate-student housing community at a US university. Social exposure was measured using Bluetooth proximity sensing technology in mobile devices. Sleep was monitored in a naturalistic setting using a headband sleep monitoring device over a period of 2 weeks. The analysis included a total of 11 subjects (6 males and 5 females) aged 24-35 (149 subject nights). RESULTS Slow-wave sleep showed a significant positive correlation (Spearman's rho = 0.51, p < 0.0001) with social exposure, whereas light non-REM (N1 + N2) sleep and wake time were found to be negatively correlated (rho = -0.25, p < 0.01; rho = -0.21, p < 0.01, respectively). The correlation of median slow-wave sleep with median social exposure per subject showed a strong positive significance (rho = 0.88, p < 0.001). On average, within subjects, following day's social exposure was higher when (slow-wave NREM + REM) percentage was high (Wilcoxon sign-ranked test, p < 0.05). CONCLUSIONS Subjects with higher social exposure spent more time in slow-wave sleep. Following day's social exposure was found to be positively affected by previous night's (slow-wave NREM + REM) percentage. This suggests that sleep affects following day's social exposure and not vice versa. Capturing an individual's dynamic social behavior and sleep from their natural environment can provide novel insights into these relationships.
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22
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Hasegawa Y, Lavigne G, Rompré P, Kato T, Urade M, Huynh N. Is there a first night effect on sleep bruxism? A sleep laboratory study. J Clin Sleep Med 2013; 9:1139-45. [PMID: 24235894 PMCID: PMC3805798 DOI: 10.5664/jcsm.3152] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Sleep bruxism (SB) is reported to vary in frequency over time. The aim of this study was to assess the first night effect on SB. METHODS A retrospective polysomnographic (PSG) analysis was performed of data from a sample of SB patients (12 females, 4 males; age range: 17-39 years) recorded in a sleep laboratory over 2 consecutive nights. Sleep parameters and jaw muscle activity variables (i.e., rhythmic masticatory muscle activity [RMMA]) for SB were quantified and compared between the 2 nights. Subjects were classified into groups according to severity of RMMA frequency, such as low frequency (2-4 episodes/h and/or < 25 bursts/h) and moderate-high frequency (≥ 4 episodes/h and ≥ 25 bursts/h). RESULTS Overall, no first night effects were found for most sleep variables. However, total sleep time, sleep efficiency, and stage transitions showed significant time and group interactions (repeated measures ANOVAs, p ≤ 0.05). The RMMA episode index did not differ between the 2 nights, whereas the second night showed significantly higher burst index, bruxism time index, and mean burst duration (repeated measure ANOVAs, p ≤ 0.05). Five patients of 8 in the low frequency group were classified into the moderate-high frequency group on the second night, whereas only one patient in the moderate-high frequency group moved to the low frequency group. CONCLUSIONS The results showed no overall first night effect on severity of RMMA frequency in young and healthy patients with SB. In clinical practice, one-night sleep recording may be sufficient for moderate-high frequency SB patients. However, low RMMA frequency in the first night could be confirmed by a second night based on the patient's medical and dental history.
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Affiliation(s)
- Yoko Hasegawa
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, Nishinomiya City, Hyogo, Japan
- Faculté de medicine dentaire, Université de Montréal, Montréal, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
| | - Gilles Lavigne
- Faculté de medicine dentaire, Université de Montréal, Montréal, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
| | - Pierre Rompré
- Faculté de medicine dentaire, Université de Montréal, Montréal, Canada
| | - Takafumi Kato
- Department of Oral Anatomy and Neurobiology, Graduate School of Dentistry, University of Osaka, Osaka, Japan
| | - Masahiro Urade
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, Nishinomiya City, Hyogo, Japan
| | - Nelly Huynh
- Faculté de medicine dentaire, Université de Montréal, Montréal, Canada
- Centre d'étude du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
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23
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Paterson JL, Dorrian J, Ferguson SA, Jay SM, Dawson D. What happens to mood, performance and sleep in a laboratory study with no sleep deprivation? Sleep Biol Rhythms 2013; 11:200-209. [PMID: 24839396 DOI: 10.1111/sbr.12023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
There are few studies examining changes in waking function in a laboratory environment with no sleep deprivation and mood has been largely overlooked in this context. The present study examined changes in mood, performance, sleep and sleepiness in the laboratory study with no sleep deprivation. Nineteen participants (10M, 9F; 22y ± 4.2y) were given nine 9h sleep opportunities (2300-0800). Every two hours during wake, participants completed the Mood Scale II, a 10-minute Psychomotor Vigilance Task and measures of sleepiness and fatigue. Sleep was monitored using an electroencephalographic montage. Findings revealed significant negative mood change, performance impairment, reduced total sleep time and sleep efficiency (all p < .05). These findings suggest that the laboratory environment or procedural factors may impair mood, performance and sleep. These findings may have implications for interpreting impairments in mood, performance and sleep when observed in laboratory environments.
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Affiliation(s)
- Jessica L Paterson
- Central Queensland University, Appleton Institute, 44 Greenhill Road, Wayville SA 5034
| | - Jill Dorrian
- University of South Australia, School of Psychology, Social Work and Social Policy, GPO Box 2471, Adelaide SA 5001
| | - Sally A Ferguson
- Central Queensland University, Appleton Institute, 44 Greenhill Road, Wayville SA 5034
| | - Sarah M Jay
- Central Queensland University, Appleton Institute, 44 Greenhill Road, Wayville SA 5034
| | - Drew Dawson
- Central Queensland University, Appleton Institute, 44 Greenhill Road, Wayville SA 5034
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24
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Griessenberger H, Heib DPJ, Kunz AB, Hoedlmoser K, Schabus M. Assessment of a wireless headband for automatic sleep scoring. Sleep Breath 2013; 17:747-52. [PMID: 22996794 PMCID: PMC3655221 DOI: 10.1007/s11325-012-0757-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 06/20/2012] [Accepted: 07/17/2012] [Indexed: 12/04/2022]
Abstract
PURPOSE Classically, professional assessment of sleep is done in the sleep laboratory using whole-night polysomnography (PSG). However, given a misbalance between accredited sleep laboratories and the large amount of patients suffering from sleep disorders, only few receive appropriate diagnostic assessment. Recently, some low-cost home sleep scoring systems have been proposed, yet such systems are rarely tested scientifically. The aim of the present study was to evaluate the staging accuracy of the home sleep scoring system Zeo (Newton, MA, USA). METHODS A final sample of 21 nights from ten subjects (aged 23-45) was digitally recorded with PSG as well as with the Zeo system. We compared scorings of Zeo (on an epoch-be-epoch basis) with the Somnolyzer 24 × 7 (an automatic staging algorithm), expert scorers as well as the freeware SleepExplorer. RESULTS It was revealed that Zeo shows moderate overall agreement as compared to our study standard Somnolyzer 24 × 7 (κ = 0.56). The most obvious performance difference between Zeo and both other scoring approaches was stage wake (sleep onset latency + wake after sleep onset). While Zeo detected only 40.8 % of the study standard wake epochs, 70.1 % were detected by the expert scorers and 83.4 % by the SleepExplorer, respectively. CONCLUSIONS Data suggest that the Zeo system produces acceptable sleep scoring for stage REM, light and deep sleep, with a specific weakness in correctly detecting waking periods.
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Affiliation(s)
- H. Griessenberger
- Department of Psychology, Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
| | - D. P. J. Heib
- Department of Psychology, Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
| | - A. B. Kunz
- Christian Doppler Clinic, Department of Neurology, Paracelsus Private Medical University, Ignaz-Harrerstraße 79, 5020 Salzburg, Austria
| | - K. Hoedlmoser
- Department of Psychology, Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
| | - M. Schabus
- Department of Psychology, Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
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Parrino L, Ferri R, Bruni O, Terzano MG. Cyclic alternating pattern (CAP): the marker of sleep instability. Sleep Med Rev 2011; 16:27-45. [PMID: 21616693 DOI: 10.1016/j.smrv.2011.02.003] [Citation(s) in RCA: 233] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 02/21/2011] [Accepted: 02/21/2011] [Indexed: 11/16/2022]
Abstract
Cyclic alternating pattern CAP is the EEG marker of unstable sleep, a concept which is poorly appreciated among the metrics of sleep physiology. Besides, duration, depth and continuity, sleep restorative properties depend on the capacity of the brain to create periods of sustained stable sleep. This issue is not confined only to the EEG activities but reverberates upon the ongoing autonomic activity and behavioral functions, which are mutually entrained in a synchronized oscillation. CAP can be identified both in adult and children sleep and therefore represents a sensitive tool for the investigation of sleep disorders across the lifespan. The present review illustrates the story of CAP in the last 25 years, the standardized scoring criteria, the basic physiological properties and how the dimension of sleep instability has provided new insight into pathophysiolology and management of sleep disorders.
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Affiliation(s)
- Liborio Parrino
- Sleep Disorders Center, Department of Neurosciences, University of Parma, Italy
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26
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Poryazova R, Werth E, Parrino L, Terzano MG, Bassetti CL. Cyclic alternating pattern in narcolepsy patients and healthy controls after partial and total sleep deprivation. Clin Neurophysiol 2011; 122:1788-93. [PMID: 21458370 DOI: 10.1016/j.clinph.2011.02.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 02/21/2011] [Accepted: 02/24/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the regulation NREM sleep at baseline and in morning recovery sleep after partial and total sleep deprivation (SD) in narcolepsy-cataplexy (NC) using cyclic alternating pattern (CAP). METHODS Daytime sleep under either increased (no sleep in the previous night) or decreased sleep pressure (allowing 4h of sleep, 23:00-3:00 h) was recorded in ten drug-free, HLA-positive, hypocretin deficient NC patients and ten age, gender and body mass index matched healthy controls. Baseline sleep was also recorded and used for comparison purposes. CAP parameters were scored and analyzed for each subject. RESULTS Narcolepsy patients had significantly lower CAP rate, CAP index, CAP time, number of CAP cycles, A1 index and number of A1 cycles in comparison to healthy controls at baseline as well as after partial and total SD. In both narcolepsy patients and healthy control subjects there was a significant decrease in these parameters after partial and total SD but the changes followed a similar pattern. CONCLUSION The persistence of baseline differences in CAP parameters between narcolepsy patients and healthy controls and their similar behavior after partial and total SD suggests similar homeostatic NREM sleep regulation but on a different level. SIGNIFICANCE CAP analysis demonstrates that NREM sleep homeostasis although altered, is functional in narcolepsy patients.
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Seidel S, Kechvar-Parast J, Sycha T, Zeitlhofer J. The first case of a 'jumping stump' syndrome in a lower limb amputee responding to pramipexole. Eur J Neurol 2010; 18:e45-6. [PMID: 21159070 DOI: 10.1111/j.1468-1331.2010.03288.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Aricò D, Drago V, Foster PS, Heilman KM, Williamson J, Ferri R. Effects of NREM sleep instability on cognitive processing. Sleep Med 2010; 11:791-8. [DOI: 10.1016/j.sleep.2010.02.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2009] [Revised: 02/13/2010] [Accepted: 02/23/2010] [Indexed: 11/16/2022]
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29
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Ferri R, Manconi M, Aricò D, Sagrada C, Zucconi M, Bruni O, Oldani A, Ferini-Strambi L. Acute dopamine-agonist treatment in restless legs syndrome: effects on sleep architecture and NREM sleep instability. Sleep 2010; 33:793-800. [PMID: 20550020 PMCID: PMC2881713 DOI: 10.1093/sleep/33.6.793] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES To analyze cyclic alternating pattern (CAP) in restless legs syndrome (RLS) and the eventual changes induced by the acute administration of pramipexole. SETTING Sleep clinic in a scientific research institute. INTERVENTIONS Placebo or pramipexole 0.25 mg. METHODS Thirty-four patients were included: 19 patients received 0.25 mg of pramipexole and 15 were given placebo. The control group included 13 normal subjects. Nocturnal polysomnography was carried out in all subjects, and a second night was recorded after pramipexole or placebo was administered to patients with RLS. Sleep stages, CAP, and leg movement activity were scored following standard criteria. MEASUREMENTS AND RESULTS At baseline, rapid eye movement sleep latency was significantly longer in patients with RLS than in normal control subjects, and the periodic leg movement during sleep index (PLMS) was also significantly higher. On the contrary, many CAP parameters appeared to be significantly different, with a general increase in CAP rate in patients with RLS. Acute administration of pramipexole induced moderate changes in sleep architecture (increased number of stage shifts/h, sleep efficiency, and percentage of stage 2 sleep; decreased wakefulness after sleep onset; and a lower PLMS index. No effects of treatment on CAP were observed. CONCLUSION Patients with RLS show significant abnormalities in sleep microstructure, represented by an excessive sleep instability/discontinuity. Acute pramipexole administration seems to exert no action on these abnormalities; the moderate effects seen on sleep architecture might be interpreted as the beneficial consequence of the removal of presleep RLS symptoms and PLMS.
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Affiliation(s)
- Raffaele Ferri
- Sleep Research Centre, Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy.
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